That the liver, a most highly vascular organ, is readily open to invasion by Spirochaeta pallida as it enters the blood stream at the time of its dissemination through the body, is well known.
In the early stages of the disease, the cells that are susceptible to the specific toxin undergo variable degrees of degeneration. Besides the usual pathologic picture of syphilis, there is an acute vascular reaction with an associated swelling of the fine biliary ducts. The body, in an effort to destroy the spirochetes that continue to survive in spite of the high degree of resistance encountered at the end of the secondary stage, causes the production of a fibrosis. When the tissues have failed at this process, necrosis ensues, with the formation of gummas. Irrespective of the treatment instituted, these necrotic lesions tend to heal by a secondary fibrosis. According to Symmers,1 the tissues have a
IRGANG S, SALA AM. THE LIVER IN ACTIVE SYPHILISA STUDY OF ONE HUNDRED AND SEVENTY-NINE CASES OF CUTANEOUS SYPHILIS. Arch Derm Syphilol. 1930;21(4):552–557. doi:10.1001/archderm.1930.01440100036004
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